Rural/Urban Differences in Access to and Utilization of Services Among People in Alabama with Sickle Cell Disease

Abstract

Objective. This study examined relationships between socioeconomic factors and the geographic distribution of 662 cases of sickle cell disease in Alabama in 1999-2001.Methods. Measures of community distress, physical functioning, and medical problems were used in analyzing utilization differences between individuals with sickle cell disease living in urban and rural areas.Results. Utilization of comprehensive sickle cells disease services was lower for individuals with sickle cell disease living in rural areas than for those living in urban areas. Rural clients reported significantly more limitations than urban clients on several measures of physical functioning. The results also suggest that utilization of services was higher for those with more medical problems and those who lived in high distress areas, although these findings did not meet the criterion for statistical significance.Conclusions. Conclusions based on statistical evidence that geographic location and socioeconomic factors relate to significantly different health care service experience bear important implications for medical and health care support systems, especially on the community level.

Urban–Rural Dichotomy of Burn Patients in Georgia and South Carolina

“…GIS is widely used in local government planning, 20,21 disease surveillance, and epidemiology. [22][23][24] Although GIS is widely used in controlling wildfires, 25 its usage in prevention of burn injuries is relatively unknown.…”

Pediatric Neurosurgery Patients Need More than a Neurological Surgeon: A Clinical Experience

“…The withdrawal of comprehensive care for these children leads to poor outcomes [22]. Lack of availability of comprehensive multispecialty care for many chronic conditions is due to a number of financial constraints including restriction by health care plans for full reimbursement for care by providers outside of the network, lack of reimbursement for care coordination and services provided by nonmedical staff members, and limitation on the number of services that can be billed for a single visit or day [17,23]. Parents/caregivers need to navigate not only through these issues, but they also need guidance as to the resources that are available in the community.…”

Initiating a Pediatric Spasticity Program with Multispecialty and Multi-Institutional Support: A Preliminary Report

“…They utilize a vast array of specialty and allied healthcare providers. The child and the family need to receive a variety of educational, developmental and support services that are necessary from many agencies and different programs [7,8]. Comprehensive healthcare models for children with chronic medical needs have been shown to lower healthcare and social costs by reducing hospitalizations, and have led to parents and care providers losing fewer days from work [4,9,10,11,12,13].…”

“…Currently there are a limited number of comprehensive multispecialty clinics for the care of children with chronic medical needs such as spasticity. This is due to many reasons such as, but not limited to: restriction by state and private health plans for full reimbursement for care providers ‘outside of the network', lack of reimbursement for chronic healthcare coordination for individual patients, lack of reimbursement for services provided by nonmedical staff members as well as limitation on the number of services that can be billed for a single visit or day [8,9]. …”